Nida Fazal Raheman

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38544 Issued in TX

Practice address

925 N Bryan Belt Line Rd Ste 106
Mesquite, TX 75149-2541

Phone

(972) 288-3200

NPI assigned

Sep 5, 2022

Last updated

Sep 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1629799044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 WARM SPRINGS LN",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 N BRYAN BELT LINE RD STE 106",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492541",
            "telephone_number": "972-288-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHEMAN",
        "first_name": "NIDA",
        "middle_name": "FAZAL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Mesquite, TX
• Providers in Mesquite, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.